International Journal of Clinical Practice最新文献

{"title":"Baseline Left Atrial Volume Index Is Associated With Atrial Fibrillation Documented at Follow-Up After Achievement of Euthyroidism in Patients With Hyperthyroidism: An Exploratory Prospective Cohort Study","authors":"Swe Min Oo, Myint Zaw, Tun Naing Oo, Hein Zaw, Phway Mon Myo","doi":"10.1155/ijcp/7595578","DOIUrl":"https://doi.org/10.1155/ijcp/7595578","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is a common cardiovascular manifestation of hyperthyroidism. Restoration of euthyroidism frequently improves rhythm, but AF may remain detectable after thyroid normalization. We evaluated whether left atrial volume index (LAVI), measured during thyrotoxicosis, was associated with AF documented after biochemical euthyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an exploratory prospective longitudinal cohort study of 150 consecutive adults with newly diagnosed overt hyperthyroidism at a single tertiary hospital in Myanmar. Baseline clinical assessment and transthoracic echocardiography were performed during thyrotoxicosis. Participants were followed to biochemical euthyroidism and then assessed approximately 6 months later with repeat echocardiography and 24-h Holter monitoring. The primary association analysis was restricted to the 24 participants with AF at baseline. Baseline LAVI was modeled continuously using Firth penalized logistic regression. A baseline LAVI threshold of > 34 mL/m<sup>2</sup> was evaluated only as an internally derived exploratory threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four participants (16.0%) had AF at baseline. At follow-up, AF was documented in 11 of 24 participants (45.8%), while AF was not detected in 13 (54.2%). Baseline LAVI was higher among participants with AF documented at follow-up than among those without AF detected (44.2 ± 6.1 vs. 32.5 ± 4.0 mL/m<sup>2</sup>; <i>p</i> < 0.001). In the exploratory Firth model, each 5-mL/m<sup>2</sup> increase in baseline LAVI was associated with higher odds of AF documented at follow-up (adjusted OR 2.15, 95% CI 1.20–3.85; <i>p</i> = 0.01). The internally derived > 34 mL/m<sup>2</sup> threshold had an apparent AUC of 0.86 (95% CI 0.73–0.99), sensitivity of 81.8%, and specificity of 76.9%. All 150 participants achieved biochemical euthyroidism; the overall median time from treatment initiation to euthyroidism was 3.0 months (IQR 2.0–4.0; range 1.5–6.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this exploratory cohort, higher baseline LAVI was associated with AF documented 6 months after achievement of euthyroidism among patients who presented with hyperthyroidism-associated AF. LAVI should be regarded as a structural phenotype of atrial remodeling rather than a direct measure of fibrosis. The > 34 mL/m<sup>2</sup> threshold was derived and tested in the same small cohort and requires independent external validation before any clinical implementation.</p>\u0000 ","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7595578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Glucocorticoid-Related Hub Genes and Therapeutic Candidates in Polycystic Ovary Syndrome via Multiomics Integration and Machine Learning","authors":"Wei Li,&nbsp;Qi Xu,&nbsp;Jingyao Chen,&nbsp;Haiting Guo","doi":"10.1155/ijcp/6907370","DOIUrl":"https://doi.org/10.1155/ijcp/6907370","url":null,"abstract":"<p>Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder with significant diagnostic and therapeutic challenges. Increasing evidence suggests that glucocorticoids (GCs) contribute to PCOS development, yet the underlying molecular mechanisms remain unclear. In this study, transcriptomic datasets of granulosa cells from the Gene Expression Omnibus were integrated and batch-corrected to identify differentially expressed genes (DEGs). Weighted gene co-expression network analysis was performed to define GC-related modules, and hub genes were screened using machine learning algorithms. Six hub genes (CRIP1, EPS8, PCSK9, PLEKHH2, RBP7, and SYTL5) were identified as potential biomarkers, with receiver operating characteristic curve analysis confirming their strong diagnostic performance (area under the curve &gt; 0.8). A nomogram integrating these genes achieved an AUC of 0.9481, indicating superior diagnostic value. Candidate therapeutic compounds were predicted via the Drug–Gene Interaction Database and evaluated through molecular docking, which demonstrated high-affinity binding of DH376, LEI105, and DO34 to CRIP1 (binding energy &lt; −5.8 kcal/mol). Regulatory network analysis further suggested the involvement of GC-related pathways in cholesterol metabolism and insulin resistance. These findings reveal novel molecular insights into GC-associated mechanisms in PCOS, propose a six-gene diagnostic signature, and highlight CRIP1-targeting compounds, particularly DO34, as computationally predicted candidates warranting experimental validation, thereby laying a foundation for precision diagnostics and targeted therapies in PCOS.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6907370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspiration Pneumonia and In-Hospital Outcomes Among Stroke Hospitalizations in the United States: A National Inpatient Sample Study, 2016–2022","authors":"Meng Li,&nbsp;Yanda Du,&nbsp;Ziwen Xu,&nbsp;Ying Zhong,&nbsp;Yingqi Huang,&nbsp;Yaling Sun,&nbsp;Lanyuan Liao,&nbsp;Xitong Wang,&nbsp;Guixian Zhou,&nbsp;Jiani Liu,&nbsp;Fei Zhong,&nbsp;Hui Zhang,&nbsp;Qingqing Zhang,&nbsp;Xiaoyu Lin,&nbsp;Xiaojun Xiang","doi":"10.1155/ijcp/1296684","DOIUrl":"https://doi.org/10.1155/ijcp/1296684","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aspiration pneumonia is a clinically important condition among patients hospitalized with stroke. However, contemporary national evidence regarding its burden and in-hospital outcomes remains limited. This study examined the frequency of aspiration pneumonia and its association with in-hospital outcomes among stroke hospitalizations in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis using the National Inpatient Sample from 2016 to 2022. Adult hospitalizations with a principal diagnosis of subarachnoid hemorrhage, intracerebral hemorrhage, or cerebral infarction were identified using ICD-10-CM. Hospitalizations were classified according to the presence or absence of aspiration pneumonia. In-hospital mortality, major complications, length of stay, and total hospital charges were compared. Multivariable logistic regression models were used to evaluate the association between aspiration pneumonia and binary in-hospital outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 845,035 stroke hospitalizations were included, of which 37,287 had aspiration pneumonia, corresponding to a frequency of 4.41%. Hospitalizations with aspiration pneumonia had longer length of stay and substantially higher total hospital charges. After multivariable adjustment, aspiration pneumonia was associated with higher odds of sepsis (OR = 8.129; 95% CI = 7.862–8.405), cardiac arrest (OR = 3.188; 95% CI = 2.999–3.389), in-hospital death (OR = 2.896; 95% CI = 2.813–2.980), shock (OR = 2.611; 95% CI = 2.465–2.766), acute heart failure (OR = 2.595; 95% CI = 2.483–2.712), pulmonary embolism (OR = 2.350; 95% CI = 2.190–2.521), and deep vein thrombosis (OR = 2.083; 95% CI = 1.960–2.214). The mortality association remained consistent across sensitivity and stroke-subtype analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this National Inpatient Sample, aspiration pneumonia was identified in 4.41% of principal-diagnosis stroke hospitalizations and was associated with substantially higher odds of in-hospital mortality and major complications, longer hospitalization, and higher total hospital charges. These findings highlight aspiration pneumonia as an important indicator of a high-risk in-hospital course among patients with stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1296684","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet Satisfaction, Exercise Adherence and Self-Reported Weight Change: A Secondary Cross-Sectional Analysis of Participants in a Lifestyle Intervention Study","authors":"Dilara Canbay Ozdemir,&nbsp;Ecem Cakir Altinyaprak,&nbsp;Duygu Ayhan Baser,&nbsp;Izzet Fidanci,&nbsp;Arzu Demircioglu Karagoz","doi":"10.1155/ijcp/1258856","DOIUrl":"https://doi.org/10.1155/ijcp/1258856","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diet satisfaction and exercise adherence may be associated with engagement in lifestyle interventions, but their relationships with weight change in primary care remain unclear. This study examined the associations of diet satisfaction and exercise adherence with self-reported weight-change status among adults with overweight or obesity who had participated in a lifestyle intervention study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This secondary cross-sectional analysis included 102 adults aged 18–40 years with a BMI of ≥ 25 kg/m² who attended the three-month follow-up assessment of a previous lifestyle intervention study and completed the study questionnaire. All participants included in the present analysis received a calorie-restricted diet and a prescribed exercise programme. Diet satisfaction was assessed using the Diet Satisfaction Score (DSS), while adherence to prescribed exercise was assessed primarily using the validated six-item Section B of the Exercise Adherence Rating Scale (EARS-B).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DSS differed overall across the weight-change groups (<i>p</i> = 0.017), although no Bonferroni-adjusted pairwise comparison was significant. EARS-B also differed overall (<i>p</i> &lt; 0.001) and was higher in the weight-loss group than in the no-change and weight-gain groups in adjusted pairwise comparisons. In an exploratory adjusted logistic regression model, higher EARS-B was associated with greater odds of reporting weight loss (OR = 1.188, 95% CI 1.084–1.303; <i>p</i> &lt; 0.001); a sensitivity analysis using the combined EARS <i>B</i> + <i>C</i> score yielded a similar result (OR = 1.110, 95% CI 1.049–1.174; <i>p</i> &lt; 0.001). DSS and EARS-B were positively correlated (<i>ρ</i> = 0.373, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Self-reported weight-change status was associated with diet satisfaction and EARS-B scores. Because all measures were obtained concurrently and weight change was self-reported, temporal and causal inferences cannot be made.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1258856","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Toxicity of Chemoimmunotherapy Compared With Chemotherapy Alone or Targeted Therapy Plus Immunotherapy in Chronic Lymphocytic Leukemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Aviwe Ntsethe,&nbsp;Phiwayinkosi Vusi Dludla,&nbsp;Bongani Brian Nkambule","doi":"10.1155/ijcp/6117510","DOIUrl":"https://doi.org/10.1155/ijcp/6117510","url":null,"abstract":"<p>Chemoimmunotherapy remains a common treatment for chronic lymphocytic leukemia (CLL), but its efficacy and toxicity relative to chemotherapy alone or targeted therapy plus immunotherapy are unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) compared progression-free survival (PFS), overall survival (OS), and grade ≥ 3 adverse events between chemoimmunotherapy and these two comparators in patients with CLL. This review followed PRISMA 2020 guidelines. EBSCOhost and PubMed were searched from inception to 11 April 2026. Hazard ratios (HRs) for PFS and OS and relative risks (RRs) for grade ≥ 3 adverse events were pooled using random-effects models in <i>R</i> (Version 4.4.2, “meta” package). Risk of bias was assessed with a modified Downs and Black checklist. Eleven RCTs comprising 5925 patients (pooled mean age 66.35 ± 10.7 years) were included. Compared with conventional chemotherapy, chemoimmunotherapy showed a lower hazard of disease progression (HR: 0.54, 95% CI: 0.43–0.68; <i>p</i> = 0.280) but significantly increased the risk of grade ≥ 3 neutropenia (RR: 1.74, 95% CI: 1.38–2.19; <i>p</i> = 0.0046); the difference in grade ≥ 3 anemia risk was not statistically significant (RR: 0.75, 95% CI: 0.55–1.03; <i>p</i> = 0.061). Compared with chemoimmunotherapy, targeted therapy plus immunotherapy significantly improved PFS (HR: 0.29, 95% CI: 0.20–0.42; <i>p</i> &lt; 0.0001) and significantly reduced the risk of grade ≥ 3 neutropenia (RR: 0.78, 95% CI: 0.63–0.98; <i>p</i> = 0.030) and anemia (RR: 0.52, 95% CI: 0.33–0.83; <i>p</i> = 0.006). Heterogeneity was substantial across analyses (I² up to 90%). Targeted therapy plus immunotherapy offers superior efficacy and a more favorable safety profile than chemoimmunotherapy, particularly in high-risk and treatment-naïve patients with CLL. Chemoimmunotherapy is associated with greater toxicity but comparable efficacy relative to conventional chemotherapy alone. These findings warrant cautious interpretation given the substantial heterogeneity observed.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6117510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Regional Thoracolumbar Soft-Tissue Stiffness and Pain Parameters in Young Adults With or Without Chronic Nonspecific Low Back Pain: A Case-Control Study","authors":"Zehra Can Karahan,&nbsp;Naime Uluğ","doi":"10.1155/ijcp/4819980","DOIUrl":"https://doi.org/10.1155/ijcp/4819980","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Chronic nonspecific low back pain (CNSLBP) is a prevalent condition among young adults. While recent evidence suggests that the posterior connective tissue architectures and the thoracolumbar fascia (TLF) may contribute to pain mechanisms, in vivo surface measurements capture composite tissue properties rather than an isolated fascial sheet. This study aimed to investigate regional myofascial biomechanical properties and pain-related parameters in young adults with and without CNSLBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This exploratory case-control study included 50 participants aged 18–29 years, divided into a CNSLBP group (<i>n</i> = 25) and an age- and sex-matched asymptomatic control group (<i>n</i> = 25). Pain intensity was assessed using a 10-cm Visual Analog Scale (VAS) and localized pressure pain thresholds (PPT) using a digital pressure algometer. Regional soft-tissue biomechanical properties (dynamic stiffness, tone, and logarithmic decrement) were measured bilaterally at the L1 and L3 vertebral levels and the 12th rib (latissimus dorsi region) using the MyotonPRO device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Demographic characteristics were similar between groups (<i>p</i> &gt; 0.05). PPT values were significantly lower in the CNSLBP group at the left latissimus dorsi, right L1, and left L1 and L3 levels compared to controls (<i>p</i> &lt; 0.05), indicating localized mechanical hyperalgesia. Regional myofascial dynamic stiffness was significantly higher on the right side of the latissimus dorsi region in the CNSLBP group compared to controls (<i>p</i> = 0.027). No significant group differences were observed for oscillation frequency (tone) or logarithmic decrement across other assessed sites (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Young adults with CNSLBP exhibited increased regional tissue stiffness in the right latissimus dorsi and reduced PPTs at several thoracolumbar sites. As surface myotonometry reflects composite soft-tissue behavior rather than isolated fascial properties, these findings indicate localized alterations in regional soft-tissue mechanics and mechanical pain sensitivity. Further studies are needed to determine the clinical relevance of these alterations and whether they are modifiable through intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4819980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Strangulation Risk in Acute Irreducible Inguinal Hernias: Development and Validation of an Integrated Model Using Inflammatory Markers and Imaging Features","authors":"Yongzheng Xie,&nbsp;Haiyun Deng,&nbsp;Zhaohui Shi,&nbsp;Meng Wang,&nbsp;Binjie Wang,&nbsp;Changbo Li,&nbsp;Li Zheng","doi":"10.1155/ijcp/4920030","DOIUrl":"https://doi.org/10.1155/ijcp/4920030","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Accurately predicting strangulation risk in acute irreducible inguinal hernia remains a clinical challenge. This study aimed to develop and validate an integrated model using routinely available inflammatory markers and imaging features for preoperative risk assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of adults with acute irreducible inguinal hernia at a single center (January 2020–August 2024). Predictors were drawn from clinical, laboratory (including inflammatory indices) and imaging domains. We employed a three-stage analytical framework: (1) univariate screening with <i>t</i>-tests or Mann–Whitney <i>U</i> tests, (2) variable refinement using LASSO regression on significant univariate predictors, and (3) definitive model construction via multivariable logistic regression. Model performance was evaluated by its area under the curve (AUC), calibration (calibration plot and Hosmer–Lemeshow test), and clinical utility (net benefit on decision curve analysis, DCA). Model stability was assessed through 10-fold cross-validation and 1000 bootstrap internal validations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 988 screened hernia patients, 84 met the inclusion criteria. The intraoperative findings confirmed bowel strangulation in 40 patients (47.6%). The final model, the Inguinal Hernia Strangulation Risk Score (IHS-RS), incorporated five independent predictors: pelvic effusion (odds ratio [OR]: 8.77), age cohort (OR: 2.12), femoral hernia (vs. nonfemoral) (OR: 2.28), neutrophil count (OR: 1.26), and blood urea nitrogen (OR: 1.19). The model showed strong discrimination with an apparent AUC of 0.847 (95% CI: 0.762–0.933) and an internally validated AUC of 0.790 on 10-fold cross-validation, good calibration (Hosmer–Lemeshow test <i>p</i> = 0.809), and provided a positive net clinical benefit across a range of threshold probabilities on DCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The IHS-RS, integrating five readily available preoperative variables, offers a practical tool for preoperative risk stratification. It has the potential to aid surgical planning and optimize triage and referral decisions for frontline clinicians managing acute irreducible inguinal hernia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4920030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning–Based Classification of Prevalent Hypertension Among Middle-Aged and Elderly Adults in Chengdu, China","authors":"Shan Liu,&nbsp;ShuJie Meng,&nbsp;Yong Li,&nbsp;Xia Wang,&nbsp;Liu Lu,&nbsp;Juan Lian,&nbsp;Caiyi Ma,&nbsp;Rong Zhang,&nbsp;Ru Gao","doi":"10.1155/ijcp/6817934","DOIUrl":"https://doi.org/10.1155/ijcp/6817934","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hypertension remains a major public health concern worldwide, particularly among middle-aged and elderly populations; in China, the prevalence among adults has reached 31.6%, and the burden in rapidly urbanizing regions such as Chengdu continues to rise with changing dietary and lifestyle patterns. Identifying individuals with hypertension in hospital-based check-up settings is important for timely management. Machine learning, which can capture nonlinear relationships among routinely collected questionnaire-based variables, may improve the classification of prevalent hypertension in this population.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to assess the prevalence of hypertension among middle-aged and elderly residents in Chengdu, China, to identify key factors associated with hypertension, and to compare the discrimination and calibration of multiple machine learning algorithms in classifying prevalent hypertension.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 14,573 individuals aged ≥ 45 years who underwent routine physical examinations at a tertiary general hospital in Chengdu between January and December 2023 were included. Demographic and lifestyle data were collected using standardized questionnaires. Participants were randomly divided into a training set (&lt;i&gt;n&lt;/i&gt; = 13,116) and a validation set (&lt;i&gt;n&lt;/i&gt; = 1457) in a 9:1 ratio using stratified sampling. To avoid feature-selection leakage, univariate analysis, multivariable logistic regression (LR), and collinearity diagnosis were performed exclusively within the training set, yielding 11 independent predictors; the validation set did not participate in any feature- or model-selection step. Four machine learning models, extreme gradient boosting (XGBoost), random forest (RF), LR, and least absolute shrinkage and selection operator (LASSO), were developed, with the synthetic minority oversampling technique applied only to the training folds and hyperparameters tuned by grid search with 10-fold stratified cross-validation. A nomogram was constructed based on the LR model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, Youden index, and Brier score, with the classification cutoff determined by maximizing the Youden index in the training set.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among the 14,573 participants, 2823 (19.4%) were diagnosed with hypertension. Eleven independent predictors were identified, including age, sex, employment s","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6817934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Function in Different Subtypes of Prediabetes and Its Relationship With Insulin Resistance and Hand Grip Strength","authors":"Yeonsook Moon,&nbsp;Noriyoshi Fujii,&nbsp;Tatsuyoshi Fujii,&nbsp;Jong Weon Choi","doi":"10.1155/ijcp/9611248","DOIUrl":"https://doi.org/10.1155/ijcp/9611248","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung function is reduced in patients with diabetes. However, few studies have examined pulmonary function and spirometric patterns in prediabetes (PDM) subtypes. This study investigated the differences in respiratory function among PDM subtypes and their relationship with insulin resistance and muscle strength in patients with PDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data obtained from 2560 participants, including 1480 patients with PDM and 1080 healthy individuals, were evaluated. Spirometric indices, such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), FEV exhaled in 6 s (FEV₆), peak expiratory flow rate, and percentage of predicted FVC (%pFVC) and FEV₁ (%pFEV₁), were measured. Muscle strength was evaluated by measuring hand grip strength (HGS). PDM was categorized into three subtypes: impaired fasting glucose (IFG), hemoglobin A1c (HbA1c)-defined PDM (A-PDM), and combined IFG and A-PDM (GA-PDM). The homeostasis model assessment of insulin resistance (HOMA-IR) was used to estimate insulin resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with PDM had significantly lower %pFVC and FEV₆ than healthy individuals, with a 1.4-fold higher prevalence of restrictive spirometric patterns. GA-PDM was more prevalent in individuals with low FVC than in those with high FVC. However, no significant difference was observed in the prevalence of IFG between the two groups. HOMA-IR and HbA1c levels were closely correlated with %pFVC and %pFEV₁. A-PDM and GA-PDM increased the risk of low FVC by 1.2- and 1.3-fold, respectively (odds ratios: 1.274, 95% CI, 1.012–1.604, <i>p</i> = 0.039 and 1.311, 95% CI, 1.042–1.648, <i>p</i> = 0.021, respectively). Patients with A-PDM had significantly lower HGS than those with IFG, particularly in men. After adjusting for potential confounders, HGS was significantly associated with %pFVC and %pFEV₁ values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Respiratory function is more significantly reduced in patients with A-PDM or GA-PDM than in those with IFG, particularly in relation to insulin resistance and decreased muscle strength.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9611248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Inflammatory and Nutritional Indices With MASLD in Adolescents: A Cross-Sectional Study of U.S. and Chinese Populations","authors":"Congwei You,&nbsp;Ruli Wang,&nbsp;Hongmei Hou,&nbsp;Cai Tang,&nbsp;Le Zhang,&nbsp;Xiaodie Yao,&nbsp;Minkai Cao","doi":"10.1155/ijcp/4045868","DOIUrl":"https://doi.org/10.1155/ijcp/4045868","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As MASLD becomes increasingly prevalent among adolescents, it is emerging as a public health concern. However, most research to date has focused on adults, and investigations in adolescents remain limited, especially regarding the role of inflammatory and nutritional indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the National Health and Nutrition Examination Survey (NHANES) and the Wuxi (China) cohort, we investigated the associations between inflammatory and nutritional indices and MASLD in adolescents from both the United States and China. To measure the associations of five inflammatory and nutritional indices with MASLD in adolescents, multivariate logistic regression analysis was conducted. Restricted cubic spline (RCS) models were applied to explore potential nonlinear associations between these indices and MASLD. Receiver operating characteristic (ROC) curve analysis was performed to assess predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1339 adolescents from NHANES and 582 from the Wuxi cohort, with 327 (24.4%) and 55 (9.4%) diagnosed with MASLD, respectively. Multivariate logistic regression analysis revealed that monocyte-to-albumin ratio (MAR), platelet-to-albumin ratio (PAR), leukocyte-to-albumin ratio (LAR), and C-reactive protein-to-albumin ratio (CAR) were significantly positively associated with MASLD (all <i>p</i> &lt; 0.001) in both cohorts, whereas neutrophil-percentage-to-albumin ratio (NPAR) reached statistical significance only in the NHANES cohort. In addition, RCS analysis revealed significant nonlinear associations of PAR and CAR with MASLD risk in the NHANES cohort. Notably, MAR, CAR, and LAR demonstrated acceptable predictive abilities for MASLD in the adolescent population and maintained modest discriminatory performance after stratification by disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings revealed that MAR, PAR, LAR, and CAR are strongly associated with an increased risk of MASLD in adolescents across both cohorts, while NPAR was significant only in the NHANES cohort. MAR, CAR, and LAR showed acceptable predictive performance, indicating their potential as adjunctive screening tools for early MASLD risk assessment in adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/4045868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}